<div class="judul_content">Tambah Data Bank</div>
<form class="form" name="form_tambah" action="utama.php?module=mod_bank&act=simpan" method="post">
     <ul>
        <li>
            <label>Nama Bank</label>
            <input type="text" name="name" id="name" class="form" size="40">
        </li>
        <li>
            <label>Nomer Rekening</label>
            <input type="text" name="rekening" id="rekening" class="form" size="40">
        </li>
        <li>
            <label>Nama Pemilik</label>
            <input type="text" name="pemilik" id="pemilik" class="form" size="40">
        </li>
        <li>
            <label>&nbsp;</label>
            <input type="reset" name="reset" value="Reset" class="reset">
            <input type="submit" name="submit" value="Simpan" class="tambah">
        </li>
    </ul>
</form>       